CVD Does Not Modify Depression-Mortality Link in Elderly

Depression tied to higher death risk in older adults; CVD explains just small fraction of excess mortality

THURSDAY, Feb. 14, 2019 (HealthDay News) -- In older adults, the association between depressive symptoms and mortality is not influenced by the presence of cardiovascular disease (CVD), according to a study recently published in the Journal of the American Geriatrics Society.

Renaud Péquignot, M.D., Ph.D., from Paris Descartes University, and colleagues evaluated the association between depressive symptoms at repeated study visits (at baseline between 1999 and 2001 and after two, four, seven, and 10 years of follow-up) and all-cause and cause-specific mortality among 7,377 participants (mean age, 73.8 years) without a history of CVD at baseline. Researchers considered the influence of CVD on the association.

The researchers found that depressive symptoms were present in 19 to 22 percent of participants at each study visit. During a median 9.4 years of follow-up, 650 patients developed a first CVD and 1,255 died. Time-dependent depressive symptoms were associated with an increased risk for mortality (hazard ratio, 1.28; 95 percent confidence interval, 1.06 to 1.55) and an incident CVD event (hazard ratio, 1.63; 95 percent confidence interval, 1.30 to 2.04) after adjustment for baseline sociodemographic variables, vascular risk factors, impairment in daily life activities, and antidepressants. The occurrence of CVD did not influence the association between depressive symptoms and mortality (hazard ratio for depressive symptoms and CVD interaction, 1.03; 95 percent confidence interval, 0.66 to 1.61). Incident CVD explained only 6.9 percent of the excess of mortality associated with depressive symptoms.

"These study results suggest that in depressed elderly individuals, the prevention [of] mortality will not be achieved by the sole prevention of CVD," the authors write.